Thursday, December 21, 2006

Weight Loss, a Cinch*

While reading Greg Critser's Fat Land: How Americans Became the Fattest People in the World, I came across a provocative and surprisingly effective method for preventing regain of pounds shed: a waist cord. The technique was lost among research findings of the 1980s and 90s because, well, it just wasn't fashionable. I mean that both figuratively (Atkins, South Beach, Zone, even Weight Watchers were definitely more vogue-y) and literally (tying fishing line around your midsection doesn't lend itself to midriff-baring chic.)

In 1981, Garrow and Gardiner published some of the first findings.1 After significant weight loss - achieved through jaw wiring - 7 women were fitted with a waist cord, 9 were not. Those with the cord regained about 12 pounds in 10 months (14% of weight lost), those without the cord regained about 39 pounds (58% of weight lost). Those are some mighty fine statistics, made evident in the mighty fine graph below:

A 1986 study published in the International Journal of Obesity reported similar results using an adjustable cord (it could be tightened but not lengthened) during a protein-sparing fast.2

Method

Garrow used a 2 mm nylon cord. It remained in place 24 hours a day:

"... ideally it had to produce no indentation of the skin with the patient supine but make a white (not red) line on the skin when the patient was seated. The length of the cord was adjusted until this tension was achieved, and the knot was then sealed by melting the ends of the cord gently, taking care not to burn the patient."

Given that "those who complete weight-loss programs ... regain two-thirds of it back within 1 year and almost all of it back within 5 years."3, a waist cord seems like the way to go. It's less invasive and less costly than gastric bands, gastric balloons, and gastric bypass. And I hypothesize it operates by a similar mechanism: pressure against the wall of the stomach stimulates nerves that signal to the brain that the stomach is full.